Tai chi, physiologic complexity, and healthy aging

描述（由申请人提供）：“什么是健康老龄化？”和“我们如何促进它”是越来越重要的，因为我们的老年人口迅速扩大。衰老是一种复杂的系统现象，是由多个生理系统同时恶化导致的身体和认知功能下降以及适应压力的能力下降。我们的研究团队和其他人已经表明，衰老生理系统的完整性和相互依赖性可以通过使用从系统生物学和复杂性理论中提取的定量工具来检查其时刻到时刻动态的“复杂性”来研究。这些研究表明：1)衰老与多种生理系统分形复杂性的丧失有关；2)复杂性指数往往比传统方法更能准确地预测健康和疾病。然而，很少有研究评估随着年龄增长而丧失的生理复杂性是否可以通过有针对性的干预来减轻或恢复。太极拳是一种基于中医整体模式的多成分身心锻炼。其明确的目标是针对多种生理过程并整合其动态，使其特别适合在复杂性框架内进行评估。据报道，太极拳可以改善许多与年龄有关的健康问题，如心血管功能、平衡、步态、自我效能和生活质量。迄今为止，很少有人尝试使用复杂性测量来研究太极拳对与年龄相关的生理过程的影响，并将这些测量与功能状态联系起来。这些知识可以提高对多成分身心运动如何影响健康和衰老的临床和机制理解。为了评估太极拳对年龄相关的复杂性丧失的影响，我们提出了一项两组前瞻性随机临床试验。我们的首要目标是评估六个月的太极训练，与接受标准医疗护理的候补对照者相比，是否可以提高未接触太极的老年人的生理复杂性和适应性。该研究的次要目标是表征复杂性生物标志物、功能测量和恢复力之间的关系。该试点研究将通过提供有关招募和保留、依从性、剂量依赖效应、效应大小的初步估计以及复杂性、功能和适应能力的最佳生物标志物的信息，为未来更明确的试验提供信息。

DESCRIPTION (provided by applicant): The questions 'what is healthy aging?' and 'how do we promote it' are increasingly relevant due to our rapidly expanding elderly population. Aging is a complex systemic phenomenon that results from concomitant deterioration of multiple physiological systems resulting in diminished physical and cognitive function and decreased ability to adapt to stress. Our research team and others have shown that the integrity and interdependence of aging physiologic systems can be studied by examining the "complexity" of their moment-to-moment dynamics using quantitative tools drawn from systems biology and complexity theory. These studies suggest that: 1) aging is associated with loss of fractal-like complexity in multiple physiological systems; and 2) indices of complexity are often more sensitive predictors of health and disease than conventional measures. However, little research has evaluated whether the physiological complexity lost with age can be attenuated or restored with targeted interventions. Tai Chi is a multi-component mind-body exercise grounded in the holistic model of traditional Chinese medicine. Its explicit goals of targeting multiple physiological processes and integrating their dynamics make it particularly suited for evaluation within a complexity framework. Tai Chi is reported to improve many age- related health issues such as cardiovascular function, balance, gait, self-efficacy, and quality of life. To date, few have attempted to study Tai Chi's impact on age-related physiological processes using complexity measures and to relate such measures to functional status. Such knowledge could generate improved clinical and mechanistic understanding of how multi-component mind-body exercises impact health and aging. To evaluate Tai Chi's effect on age-related loss of complexity, we propose a two-arm prospective randomized clinical trial. Our overarching goal is to evaluate if six months of Tai Chi training, compared to a waitlist control receiving standard medical care, can enhance physiological complexity and adaptability in older Tai Chi-naive adults. Secondary goals of the study are to characterize the relationship between complexity biomarkers, measures of function, and resilience. This pilot study will inform a future more definitive trial by providing information on recruitment and retention, compliance, dose-dependent effects, preliminary estimates of effect size, and the optimal biomarkers of complexity, function, and adaptive capacity. PUBLIC HEALTH RELEVANCE: Understanding the biology of aging, and evaluating interventions that promote healthy aging are becoming increasingly important priorities. Using mathematical tools drawn from the emerging field of complexity and systems biology, this study will characterize how Tai Chi--a multipcomponent mind-body exercise--impacts moment-to-moment variations in heart beat, gait, and balance control, as well as the relationship of these patterns to more traditional measures of physical and mental function. Results of this study may lead to novel measures that help us monitor and understand the physiological processes of aging, and explore the potential benefits of Tai Chi for healthy aging.